1. Field of the Invention
The present invention relates to a laryngoscope. More particularly, the present invention relates to a laryngoscope for simultaneously spreading the epiglottis and the posterior tissue defining the superior opening of the larynx away from each other for opening up the trachea and exposing the larynx.
2. Description of the Prior Art
Laryngoscopes generally comprise a blade and a cooperating, detachable handle which are connected together into an L-shaped configuration. When using the device to view the larynx, the surface on the blade adjacent the handle is used to press against the tongue and mandible of a patient in a supine position in order to prevent the patient's tongue from obstructing the view during the visual examination. While the instrument is useful in examining the larynx, the primary function of the laryngoscope is to expose the larynx in order to facilitate the insertion of an endotracheal tube into the trachea of the lungs to administer gases.
During the use of the instrument, when pressed against the patient's tongue and mandible, the tip or distal end of the blade is usually positioned at the Junction between the base of the tongue and the base of the epiglottis which is thin, leaf shaped lamella in front of the superior opening of the larynx. With most patients, the epiglottis will be lifted sufficiently to expose the larynx by rotating the instrument anteriorly (i.e., longitudinally). Usually the patient's head is tilted backwardly to facilitate the examination.
With a small fraction of patients, the epiglottis will not be lifted sufficiently to expose the larynx in the usual laryngoscopic procedures. Unfortunately, the small percentage of patients having the anatomical structure which makes the examination of the larynx difficult cannot be determined by visually examining the epiglottis before inserting the laryngoscope. Usually, it is not until the anesthesiologist tries to expose the larynx to administer anesthetic gases, that the difficulty is encountered. The anesthesiologist must then replace the blade being used with a longer and straighter blade which is used to contact the upper edge of the epiglottis and push the epiglottis anteriorly to expose the larynx. However, the view of the larynx is not very complete in this instance and damage is frequently done to the tissue trying to push the epiglottis far enough out of the way to effectively expose the larynx.
The need for a laryngoscope which will readily expose the larynx in those patients in which the normal laryngoscopic procedures do not work has been long felt. The present invention satisfies these needs.
This need has been forfilled by U.S. Pat. No. 4,573,451 to Bauman, which is incorporated herein by reference thereto, and which forms the basis for the improvements taught by the present invention.
Generally Bauman teaches a laryngoscope blade which has a tip at the distal end thereof which is capable of being bent or flexed in the direction of the handle of the laryngoscope. Operable means are provided, preferably at the proximal end of the blade, to bend or flex the tip. When the blade is inserted into a patient's throat so that the bendable tip is located at the base of the patient's epiglottis, the operable means of the bendable tip can be actuated so the tip will bend and thereby further lift the patient's epiglottis in order to expose the patient's larynx. The laryngoscope blade is particularly suitable to the few patients in which the usual laryngoscopic procedures do not adequately expose the patient's larynx.
Typically, as shown in FIG. 1, the laryngoscope 10 has a stationary handle 11, a stationary blade 13 having a proximal end 15 from which it extends generally normally forwardly from the stationary handle 11 and a distal end 17, a tip 19 pivotally attached to the distal end 17 of the stationary blade 13, a movable handle 23 pivotally attached to the proximal end 15 of the stationary blade 13 and operatively connected to the tip 19, and an arm 25 operatively attached to the movable handle 23 and the tip 19 and pivoting the tip 19 downwardly when the movable handle 23 is moved towards the stationary handle 11 for depressing the epiglottis. In contradistinction, as best seen in FIGS. 2 and 3, the flexible tip laryngoscope 10 of the present invention has a double set of blades wherein the addition of a movable blade 22 is for clearing a path for a fiber optic seeing stylet 46 and simultaneously lifting patient's epiglottis 12 while pushing the tongue and the posterior pharyngeal wall out of the way so as to permit light from the light tip element 48 of to illuminate the path way and facilitate the inserting of intubation tube 50.
Numerous other innovations for laryngoscopes have been provided in the prior art that will be described. Even though these innovations may be suitable for the specific individual purposes to which they address, however, they differ from the present invention.
A SECOND EXAMPLE, U.S. Pat. No. 3,943,920 to Kandel teaches a laryngoscope blade that includes an upper wall, a lower wall, and a side wall joining the upper and lower walls. The upper wall includes an upper lip engaging portion and an upper gum engaging portion which are contiguous with one another. The lower wall includes a tongue engaging portion and a tip portion disposed for engaging and lifting the epiglottis. The gum portion is substantially parallel to a major extent of the lower wall, whereas the lip portion extends at an acute angle with respect thereto. An inner surface of the upper wall, at the juncture of the gum portion and the lip portion, is provided with a groove and the inner surface of the tip portion is provided with another groove. The bottom surfaces of the grooves are aligned with one another, such that a line of sight extends along such surfaces from each end of the blade.
A THIRD EXAMPLE, U.S. Pat. No. 4,114,609 to Moses teaches a laryngoscope blade comprising an essentially straight blade portion have the inner end portion which is curved out of the plane of the straight blade portion, and which curved portion is adapted to be received in the groove defined between the base of the tongue and the epiglottis of a patient whereby the tip end causes the tongue to be moved anteriorly to expose the inlet of the larynx and the straight portion of the blade defines a line of sight directly into the larynx.
A FOURTH EXAMPLE, U.S. Pat. No. 4,592,343 to Upsher teaches an improved laryngoscope having a blade which is curved and tubular and has an improved light means for illuminating the forward end of the blade. In a number of embodiments of the laryngoscope, a light source is mounted in the upper end of the handle of the laryngoscope so the handle can be used with a conventional laryngoscope blade or a non-conventional laryngoscope blade. In one embodiment, the light source is carried by an adapter removably mounted on the handle near the location where the handle and blade are interconnected.
A FIFTH EXAMPLE, U.S. Pat. No. 5,003,962 to Choi teaches a laryngoscope with an improved double-angle blade or spatula which has three segments lengthwise. The first segment extends in a direction substantially normal to the handle to a first bend, at which the blade or spatula is bent toward the handle through an angle of 20 degrees. The second segment extends in a new direction to a second bend inward through an angle of 30 degrees, forming a third segment which extends to the distal tip. A small cylindrical bulb is superposed adjacent to and parallel to the top edge, near the end of the second segment. This is energized by batteries in the handle.
A SIXTH EXAMPLE, U.S. Pat. No. 6,251,069 B1 to Mentzelopoulos et al. teaches a laryngoscope having a flexible blade which is hinged and having in the handle articulation control for the hinged portion of the blade as well as an actuator for a pair of balloons on the blade connected with double-lumen tubes.
It is apparent that numerous innovations for laryngoscopes have been provided in the prior art that are adapted to be used. Furthermore, even though these innovations may be suitable for the specific individual purposes to which they address, however, they would not be suitable for the purposes of the present invention as heretofore described.